The tobacco industry used Dr. Samet’s testimony to launch its attack on the science of secondhand smoke this morning.

The morning session began with DOJ’s Sharon Eubanks taking the astoundingly accomplished Dr. Jonathan M. Samet–Senior Scientific Editor for the 1994 Surgeon General’s Report–through a brief history of smoking and the major scientific reports on smoking and health, from Raymond Pearl (1938) on–including important papers on nicotine addiction and secondhand smoke.

One of the documents involved data from the 2004 Surgeon General’s report which the Defense had not been presented with. They objected that this and other documents should not be allowed as evidence. Judge Kessler said, this very thing was an acknowledged problem with many of the witnesses, who are so intimately connected with the subject of the trial, and who are continuing to publish and take part ongoing research. This issue had apparently been previously discussed among DOJ, Defense and Judge Kessler. She said the SG report should have come as “no surprise” to the Defense, and overruled the objection.

In discussing the part of the 94 SG Report which named new diseases associated with smoking, Judge Kessler asked a typically intelligent question. She rephrased the paragraph — accurately — and said, “cataracts and gum disease, too? (The paragraph had read, “periodentitis”.) I hadn’t known that.” She also asked to be told the differences between ETS, SHS, sidestream smoke, and mainstream smoke.

Bob McDermott (RJR) rose to cross examine Samet.

All the familiar studies, the subject of the ETS wars which began in earnest with the publication of the EPA’s 1992 report which used meta-analysis to classified secondhand smoke as a Group 1 carcinogen. When Michael Fumento wrote a critical article on the study — citing a number of tobacco-funded scientists–the race was on, and has continued to this day, from newspapers to medical journals to full page advertisements to city council chambers.

The stakes may be huge. If the industry can convince Judge Kessler on this issue–that secondhand smoke cannot be shown to significantly cause disease in nonsmokers–it will then undoubtedly go on the offensive against smokefree policies around the world.

In some circles, the battlegrounds are as famous as Gettysburg or Trafalgar: IARC, Hirayama, EPA, statistical significance, relative risk, confounding, meta-analysis, confidence levels, all are being refought here.

The afternoon session switches a bit to consideration of FTC tar/nicotine levels, and their effect on lung cancer rates.

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“The stakes may be huge. If the industry can convince Judge Kessler on this issue–that secondhand smoke cannot be shown to significantly cause disease in nonsmokers–it will then undoubtedly go on the offensive against smokefree policies around the world.”
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I respectfully disagree with Mr. Borio’s assessment here. I don’t see this as the “ultimate” battleground for tobacco and ETS, and no matter what happens at trial, tobacco has already taken the public position that it is not going to make any health claims based on ETS.

I don’t think tobacco is going to try to prove at trial that ETS does *NOT* cause cancer. Nobody can really prove a negative like that. More likely they are going to try and prove that there exists a legitimate scientific controversy about this issue, and even more specifically that their behavior with regards to ETS research has not been unreasonable, when taken into the appropriate context of time and place.

Even if Kessler decides that there is “reasonable doubt” (that’s my term) about whether or not ETS causes cancer or other diseases, that isn’t necessarily going to impact on any public health policy. There are plenty of public health policies and regional health decisions made arbitrarily, or without regard to conclusive science; it happens every day, and it isn’t even necessarily a bad thing.

Put differently, just because we couldn’t prove that there are/were weapons of mass destruction in Iraq, that doesn’t mean it was necessarily unreasonable to believe they were there and invade. Ditto for risk of cancer and public health policy towards second-hand smoke.

Consumer Reports, 1995:
“In the 1950s and 1960s, the tobacco industry mounted a campaign to keep doubt alive about the consequences of smoking. The effort ultimately flopped. But it succeeded in putting off that day when everyone acknowledged the hazard. That delay bought years of robust sales. The industry is at it again, only this time the target is secondhand smoke.”http://www.gaspforair.org/gasp/gedc/artcl-new.php?ID=40

Some of these articles on the Web are simply amazing. I wasn’t aware that anyone ever proved that second-hand smoke does anything besides annoy people and make your eyes water. If someone gets lung cancer, what percentage was contributed by second-hand smoke? Environment? Genetics? If I line up 50 people with lung cancer, how can you pick out the ones who supposedly got it from second-hand smoke? If a person walks by smoke once in their entire life, the anti-tobacco crowd would attribute it to second-hand smoke. I will agree that second-hand smoke is probably not healthy, but this is ridiculous.

I wasn’t aware that anyone ever proved that radon was that bad for you.

Oh wait; no one ever pushes that view. Everyone’s aware that radon causes cancer. No one spends millions to “keep doubt alive” on radon.

And it has paid off for the industry. You really do hear people uttering things like “I wasn’t aware that anyone ever proved it does anything besides annoy people and make your eyes water” about secondhand smoke. You don’t hear anyone say that about radon.

Honestly, how is all this propaganda any different than the tobacco executives denying the risks of cancer? The websites you link are from groups interested in banning smoking altogether. How is that objective or “reasonable”?

Fully 1/6 of lung cancers occur in people who don’t smoke (more in certain populations). That some of these sick people want to blame their disease on ETS exposure is hardly remarkable. That doesn’t make them right, even if they really believe it. Or do you actually believe that EVERY lung cancer is caused by smoking or ETS exposure?

I knew a woman who swore that Pepsi cola was the cause of her breast cancer. I know another who blamed his brain cancer on his cellular telephone. I could go on. . .

If, as you say, bans on smoking don’t decrease business, why do few-to-no businesses voluntarily choose to go “non-smoking”? Are they all financial idiots? That banning smoking reduces their business is not even debateable; the only question being a normative judgement about whether or not its “worth it” to protect the public (who are ostensibly too stupid to protect themselves by taking their business elsewhere).

Low levels of Radon have been shown to be 4 times as dangerous as high levels of second hand smoke. There was a lot of controversy about that when the studies came out, and there is still is. Nobody is advocating for Radon simply because nobody has any financial interest in doing so, and the problem is readily dealt with by ventilation. That’s the reality of politically applied science. But just because tobacco has an economic interest in showing that various ETS studies are bad doesn’t make them wrong in doing so. If the science is faulty, how are they wrong to attack it?

For example, when tobacco-hating junk scientists claim with a straight face that no amount of ventilation can make a public place where people smoke safe, should tobacco just accept that? How about when partisan tobacco haters use a badly designed (non-peer reviewed) “study” to prove that elimination of public smoking has caused the heart attack rate in a certain jurisdiction to decrease by 75%? Should tobacco just accept that nonsense at face value? The medical community is not likely to attack these frauds; they just don’t make it into peer reviewed journals, and spout in the popular media instead. So if if tobacco doesn’t criticize these charlatans, who will?

“The websites you link are from groups interested in banning smoking altogether”

Incorrect. But entirely in line with the accuracy of analysis provided.

“should tobacco just accept that?”

Gosh no, the poor little plant shouldn’t.

The good news for the plant: it has a two hundred billion dollar industry known as Big Tobacco that will fight for it. Hurray! A carcinogen with a cheering squad. What good luck!

“So if if tobacco doesn’t criticize these charlatans, who will?”

Golly, that poor little plant; it can’t attack science it doesn’t like. Wait a minute, here comes the cheering squad! Gosh that was close. Thank goodness for Big Tobacco. It will bash science, and scientists, and science reporting, and journalists, and anyone who speaks the truth about what its product does to the customer and to the people closests to the customer. Hurray!

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